Abstract

Virological outcome in patients harboring the M184V mutation treated with or without lamivudine (3TC) or emtricitabine (FTC)

G. Viloria, M. Kundro, J. Toibaro, M. Losso

Hospital General de Agudos José M Ramos Mejía, Servicio de Inmunocomprometidos, Buenos Aires, Argentina

Background: Development of M184V mutation confers high-level resistance to 3TC/FTC. Previous data suggest that continuation of 3TC/ FTC in presence of M184V may confer residual efficacy, maintaining viral population with reduced fitness. Optimal clinical management of HIV harboring M184V mutation was not clearly defined.
Methods & Objectives: To compare virological outcome in patients who had M184V and who started new treatment with or without 3TC/FTC.
A retrospective study was designed to capture clinical, demographic, laboratory and treatment data from patients harboring the M184V mutation who started a regimen with or without 3TC/FTC.
Results:

	3TC/FTC group, n=54	No 3TC/FTC group, n=24	p
Age median, years (IQR)	39 (34-46,2)	40 (33,5-48,7)	0.66
Years of diagnosis (median)	10,5 (6-13,25)	11 (7,25-13,75)	0.52
Median Baseline CD4 (IQR)	200 (91-268)	169 (89-356)	0.84
Median log HIV-RNA at baseline (IQR)	4.29(3.79-4.70)	3.97(3.45-4.78)	0.87
Median n of previous regimens (IQR)	2 (1-3)	2 (1-3)	0.79
Median baseline NNRTIs mutations, (IQR)	1 (1-2)	1 (1-2)	0.99
Median baseline PI mutations, (IQR)	0 (0-2)	0 (0-2)	0.61
Median n of active drugs used (IQR)	3 (2-3)	3 (3-3)	0.13

[Baseline characteristic of patients]

	3TC/FTC group, n=54	No 3TC/FTC group, n=24	p
Median 48 w CD4 (IQR)	282 (176- 416)	298 (119-501)	0.97
HIV-RNA <50 cps/ml at 24 w, %	77%	47%	0.018
HIV-RNA <50 copies at 48 w, %	78%	50%	0.027
HIV-RNA <400copies at 24 w,%	83%	89%	0.54
HIV-RNA <400 copies at 48 w,%	94%	55%	0.0003

[results at 24 and 48 weeks]


Conclusions: The continuous use of 3TC or FTC in patients harboring the M184V mutation results in a better viral load control at 24 and 48 weeks in this cohort. The small sample size and the retrospective nature of this data require further prospective studies to confirm these findings, which would have relevance in settings where new drugs are not fully available.
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